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Pharmacogenetic pathway analysis for determination of sunitinib-induced toxicity
Journal of Clinical Oncology, 08/18/09
Van Erp NP et al. - In a trial to identify genetic markers in the pharmacokinetic and pharmacodynamic pathways of sunitinib that predispose for development of toxicities, it was determined that polymorphisms in specific genes encoding for metabolizing enzymes, efflux transporters, and drug targets are associated with sunitinib-related toxicities. A better understanding of genetic and nongenetic determinants of sunitinib toxicity should help to optimize drug treatment in individual pts.
Methods- A multicenter pharmacogenetic association study was performed in 219 pnts treated with single-agent sunitinib.
- 31 single nucleotide polymorphisms in 12 candidate genes, together with several nongenetic variants, were analyzed for a possible association with toxicity.
- Senetic haplotypes were developed and related to toxicity.
- Risk for leukopenia was increased when the G allele in CYP1A1 2455A/G or the T allele in FLT3 738T/C were present or CAG in the NR1I3 (5719C/T, 7738A/C, 7837T/G) haplotype was absent.
- Any toxicity higher than grade 2 prevalence was increased when the T allele of vascular endothelial growth factor receptor 2 1191C/T or a copy of TT in the ABCG2 (-15622C/T, 1143C/T) haplotype were present.
- Risk for mucosal inflammation was increased in the presence of the G allele in CYP1A1 2455A/G and prevalence of hand-foot syndrome was increased when a copy of TTT in the ABCB1 (3435C/T, 1236C/T, 2677G/T) haplotype was present.
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